Assignment:
TIA OR STROKE?
You are a neurologist at a major urban hospital. A 63 year-old stroke victim is brought to you for your neurological assessment. This patient suffered a stroke after several occlusions of branches of one of the cerebral arteries. A series of cognitive, sensory and motor tests reveal the following signs and symptoms.
The patient has completely lost the perception of the somatic senses (somatosensation) from the right side of his jaw, face and tongue. There is only minor diminishment in somatosensation from his right hand and lower arm. However, even though the patient recognizes he has an object in his right hand by touch, he has almost no ability to identify objects by touch when they are hidden from sight. Sensation in his left arm, torso and both legs is unaffected.
The patient experiences flaccid paralysis in the muscles on the right side of his jaw and face. Movements of his right hand are hesitant and uncoordinated - he can no longer play piano or type with his right hand. He can no longer move his right ring finger at all. Activity and coordination of other muscle groups appears normal.
The patient understands written and spoken words and can read and write normally. However, his speech is labored and his enunciation is severely impaired.
1. What is a TIA? What is a stroke?
2. Name and discuss some pathological conditions that could have caused the stroke suffered by this patient?
3. Even though the death of neurons accompanies a stroke, a stroke patient may partially regain the cerebral function that was lost. This recovery is likely to involve the regeneration of neurons by cell division. True or false? Why or Why not?
4. What is somatosensation? This loss of somatosensation on the right side of the patient's jaw, face and tongue indicates the loss of function in which lobe of the cerebrum? How did you arrive at this conclusion?
5. How does one interpret touch? The loss of the ability to interpret the kind of object present in his right hand by touch alone indicates damage to what area of the patient's cortex? How did you arrive at this conclusion?
6. Loss of coordinated motor function (piano playing, typing) in the right hand indicates damage to what area of the patient's cortex? How did you arrive at this conclusion?
7. Inability to move the right side of the jaw and face and right ring finger indicates damage to what area of the patient's cortex? How did you arrive at this conclusion?
8. Discuss the function of Broca's and Wernicke's areas. The difficulties that the patient has with language indicate which area of the cerebrum was damaged by the stroke? How did you arrive at this conclusion?
9. Which hemisphere was damaged by the stroke? How did you arrive at this conclusion?
10. Would speech have been affected if the stroke had occurred in the other hemisphere? Why or Why not?
11. Draw a map of the motor and sensory homunculi (either draw and scan or you can take a picture and then insert). From the somatosensory and motor disruptions described, label the areas responsible for sensation and motor control which have been afflicted?
12. From the location of the damaged areas of the cerebrum, which cerebral artery and its branches were involved in the stroke?
Attachment:- Case Study.rar